Core Leader & Co-Leaders: S. ASTHANA; C.M. CARLSSON; P. ANTUONO CLINICAL CORE (CORE B) - PROJECT SUMMARY The primary objective of the Wisconsin Alzheimer's Disease Research Center's (ADRC) Clinical Core is to provide investigators access to well-characterized, diverse patient and control populations and high-quality, standardized clinical, cognitive, cerebrospinal fluid (CSF), serum/plasma, DNA, and neuroimaging data in order to facilitate translational Alzheimer's disease research in preclinical diagnosis and early intervention. To that end, the Core conducts comprehensive clinical evaluations in patients with mild cognitive impairment and mild Alzheimer's disease, cognitively normal older controls (>65 years), and middle-aged adults (45-65 years) with varying levels of dementia risk based on their family history of the disease. The Clinical Core team works closely with all Wisconsin ADRC Cores to facilitate the overall mission of the Center by participating in outreach and recruitment activities to diverse communities; conducting standardized clinical and cognitive assessments of Core participants; gathering ancillary aging-related cognitive and clinical data, including a detailed vascular risk assessment; collecting high-quality blood, CSF, and DNA biospecimens; coordinating biospecimen collection with neuroimaging; completing standardized data reporting in a timely manner; consenting Core participants for brain autopsy; facilitating cognitive testing and CSF collection within investigator-initiated studies; and ensuring timely availability of participants, data, and biospecimens to researchers both locally and nationally. Specific Aim 1: To continue to recruit and retain a pool of well- characterized middle-aged adults who are at risk for Alzheimer's disease, yet do not yet have symptoms of the disease, as well as a cohort of patients with mild cognitive impairment for regular clinical and cognitive evaluations and biomarker assessments (magnetic resonance imaging [MRI] and CSF and blood samples) to support translational research in preclinical dementia. Specific Aim 2: To continue to recruit and retain patients with mild late-onset AD and cognitively healthy older adults to undergo structured clinical and cognitive evaluations annually and to continue to encourage participation in biomarker assessments to support translational research in dementia and normal cognitive aging. Specific Aim 3: To integrate culturally-tailored outreach, education, and clinical services to diverse communities throughout Wisconsin in order to increase awareness of brain health and encourage long-term participation and advocacy for research within underrepresented minority communities. Specific Aim 4: To continue to obtain consent from Core participants for brain autopsy to support clinical-pathologic research and to collect CSF, blood, and DNA biospecimens for translational research on preclinical markers of dementia. Specific Aim 5: To continue to provide infrastructure, resources, and services to facilitate collaborative research in preclinical dementia, normal cognitive aging, and Alzheimer's disease locally and nationally. Through this work, Wisconsin ADRC investigators hope to identify early brain changes in asymptomatic people at risk for Alzheimer's disease in order to diagnose and treat the disease before any memory loss occurs.